Can someone say "no" to suppression

Hey Grace and others,
.
What do you think?

Can someone who Herpes 2 positive say NO to taking anti herpes medication when they are dating (that is, having sex with) someone who is not positive?  It seems like everyone in the herpes world is pushing this as a MUST.  Is it a must?  Does anyone know the stats on couples (one positive, one negative) taking daily meds?  Any rough guesstimates?  Thanks.  

[gracefromHHP]

it's a personal choice only.  

If a hsv2+ male partner has a hsv2- female partner and they do nothing but avoid sex any time he has obvious genital symptoms, her risk is 8-10% of contracting hsv2 from him each year. if he takes daily suppressive therapy, her risk is cut in half. If they also use condoms consistently, her risk is 2-3% of contracting hsv2 from him each year that they are together.  

the reason we push suppressive therapy so much is - it cuts the risk of transmission to a partner in half.  This is significant and the best thing we can do to help reduce the reduction of hsv2 ( besides actually just diagnosing hsv2 in our patients since just someone being aware of being infected with the virus also significantly reduces transmission to a partner too ).   So far we don't have a vaccine to reduce infection.  Condoms only reduce transmission by 30%.  Suppressive therapy is the best tool we have and we recommend it highly. With valtrex being generic now it's even more affordable.  also since having hsv2 increases the risk of contracting hiv significantly, controlling hsv2 infection rates is something that we can do to reduce the risk of hiv infections overall too.  Contrary to popular believe, it's not a conspiracy theory by the drug companies to make more money - it's to protect people from herpes and other infections.  

grace

[tilly21]

Thank you.  Taking daily suppression to cut the risk from 3% (using condoms) to 1.5% just doesn't seem worth it? It's really not that big of a difference.  

Also,  in terms of HIV, would it be better to simply promote condom use instead of anti viral use?  Suppression is not the answer: condom use is---for HIV anyway.  

[gracefromHHP]

actually in the suppressive therapy for hsv2 and reduction in acquisition of hiv studies, even using condoms wasn't no risk for hiv infection. hsv2 causes changes in the cellular level in the body that  make you more easily infected with hiv.  Even combined together it still didn't reduce transmission of hiv as much as they thought it would :(


I totally agree, reducing transmission to a male from a hsv2+ female isn't as significant as the reduction in risk from a hsv2+ male to a hsv2 neg female.   It's totally a personal choice but certainly something to consider. I still always encourage it when a relationship is new especially and follow the recommendations myself even.  

grace

[eric22]

all this talk of infected peeple taking the  burden of not passing infection to others,,when  no one gave a damn when they passed the infection to me.
i protect MYSELF,,if someone wants to have sex with me,,it's not my problem,,it's their risk,,just as no one cared enough to tell me

[tilly21]

great info.  

i guess, from my perspective, if someone who is negative is willing to take the "risk" of entering into a sexual relationship with a positive person, they need to be willing to get infected, bottom line.  I would never try to "sell" the idea of having a relationship based solely on a 1% or 2% chance of infection.  It could end up in a lot of anger, etc., if they do end up contracting it.  Someone has to be that 1%.  The negative person needs to be able to view the infection as something they might possibly contract, and as something minor and treatable if they do. In other words, not a big deal.  Otherwise, if they go in thinking, there no way I'm going to get this, the relationship could be doomed when those little sores appear.  The promotion of suppression could indeed lull people into a false sense of security on this front.   Besides, who wants to spend their entire sex lives constantly worried about possible transmission and if this will indeed spell the end of the relationship.  Sounds like a sexual prison to me.  

I think if someone is having frequent breakouts or find the breakouts uncomfortable, then go for it.  I agree, it's a personal choice either way.  

The HIV info is very interesting.  My understanding is that HSV2 can make someone more susceptible to HIV only when they are shedding/having an outbreak because the t4 cells are sent in to the genital area by the body to help with the outbreak/shedding and it's the t4 cells that make hsv2 positive people more susceptible to HIV, not that the cells change in the body permanently or that all the cells in the body are altered.  I also wonder how could HIV (in a HSV2 positive person) not be prevented by a condom.  That doesn't make sense to me, considering that HIV is a bodily fluid based infection.  

[tilly21]

forgot to ask

are you saying the hiv can pass through a condom to infect someone who is hsv2 positive...in the case of condom failure, yes, i can see this....but if the condom is used properly and doesn't break, this just doesn't make sense